Hormonal therapy combats prostate cancer by cutting off
the supply of male hormones (androgens) such as testosterone
that encourage prostate cancer growth. Hormonal control
can be achieved by surgery to remove the testicles (the
main source of testosterone) or by drugs.
Hormonal therapy targets cancer that has spread beyond
the prostate gland and is thus beyond the reach of local
treatments such as surgery or radiation therapy. Hormonal
therapy is also helpful in alleviating the painful and distressing
symptoms of advanced disease. Further, it is being investigated
as a way to arrest cancer before it has a chance to metastasize.
Although hormonal therapy cannot cure, it will usually shrink
or halt the advance of disease, often for years.
Surgery to remove the testicles (orchiectomy or surgical
castration) is usually an outpatient procedure. The testicles
are removed through a small incision in the scrotum; the
scrotum itself is left intact. To help offset the operation's
psychological toll, some men opt for reconstructive surgery
in which the surgeon replaces the testicles with prostheses
shaped like testicles.
A variety of hormonal drugs can produce a medical castration
by cutting off supplies of male hormones. Female hormones
(estrogens) block the release and activity of testosterone.
Antiandrogens block the activity of any androgens circulating
in the blood. Still another type of hormone, taken as periodic
injections, prevents the brain from signaling the testicles
to produce androgens.